With 25×5 initiative, AMIA sets sights on tackling clinical documentation burden

By Mike Miliard for Healthcare IT News

The American Medical Informatics Association this week announced next steps for AMIA 25×5, its multi-stakeholder effort to alleviate documentation burden for U.S. clinicians.


Funded by the National Library of Medicine, the 25×5 Symposium to Reduce Documentation Burden on U.S. Clinicians by 75% by 2025 was launched this past year by AMIA in partnership with Vanderbilt University and Columbia University.

In March, AMIA established a 25×5 Task Force, chaired by Columbia’s Sarah Rossetti, RN, with the university’s Kenrick Cato, RN, acting as the AMIA Board of Directors Liaison.

The 25×5 Task Force convenes more than 20 AMIA members, divided into three separate workstreams focused on providers, IT vendors and policy.

The goal is to reduce documentation burden for U.S. clinicians to 25% of its current state in the next five years – and optimize EHR and other health IT by implementing recommendations from the 25×5 Symposium and other public-private sector organizations.

The Symposium Summary Report spotlights strategies and approaches to reduce clinician documentation burden, identifies 82 prioritized action items across four themes:

  • Accountability
  • Evidence matters
  • Education and training
  • Innovation of technology

“I am proud to lead AMIA’s efforts in this critical initiative,” said Rossetti. “Working collectively with Vanderbilt, AMIA and Columbia provided significant discovery for the recommendations and calls to action that we can now move forward with, using the expertise of our Task Force.”


As electronic health record use has increased over the past decade-plus, so has “the stress imposed by the excessive work required to generate clinical records of healthcare-related interactions,” according to AMIA.

The group notes that the clinical documentation burden has had “a proven negative impact on healthcare,” leading to clinician burnout and decreased job satisfaction, and to increased medical errors and hospital-acquired conditions.

Just today, a new KLAS report showed how clinician burnout is a worldwide problem. Another recent report found that nurses are the most likely clinicians to leave their jobs in frustration – but that those who are satisfied with their organization’s EHR are more likely to stay.

Through the 25×5 initiative, AMIA hopes to help streamline workflows and optimize clinical documentation to keep the focus on delivery of safe, continuous, high-quality, value-based patient care.

Part of that will come from improvements around billing, legal issues and regulatory requirements – with those and other related tasks reduced, eliminated or automated wherever possible so as not to require extra effort by the clinician.

Documentation for those and other nonclinical purposes “should not engage the clinician’s time and attention,” according to AMIA, which adds the 25×5 Task Force is focused on eliminating unnecessary documentation altogether – not just shifting work from one clinician to another colleague.


“Reducing documentation burden on U.S. clinicians is an urgent priority within the health care community,” said AMIA board chair and president Dr. Gretchen Purcell Jackson in a statement. “AMIA has the best access to those with the subject matter expertise necessary to tackle this challenge. Bringing together health systems, providers, vendors, and policy advocates, along with the expertise of the AMIA membership, is integral to moving forward on these efforts.”

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